PSYCHOLOGY  AND  PSYCHIATRY 


BY  SHEPHERD  IVORY  FRANZ 


4P. 


UNIVBBSITY  of  CALIFORNIA 

AT 

LOS  ANGELES 
LIBRARY 


[Reprinted  from  THE  PSYCHOLOGICAL  REVIEW,  Vol.  29,  No.  4,  July,  1922.] 


PSYCHOLOGY  AND   PSYCHIATRY1 

BY  SHEPHERD  IVORY  FRANZ 
St.  Elizabeths  Hospital,  Washington 

In   the   past   a   number  of   papers   have   dealt  with   the 
topic  assigned  to  me.     With  their  special  views  and  argu- 
ments I  shall  not  concern  myself  beyond  pointing  out  some 
of  the   difficulties  that  have  arisen  either  because  of  them 
or  as  provoking  them.     Psychiatrically,  some  of  the  writers, 
not  all  in  the  distant  past,  have  identified  psychology  with 
one  or  more  psychologists  with  whom  they  have  come  in 
contact,    sometimes    in    person    but    usually    through    their 
writings.     With  the  psychological  views  expressed  there  was 
no  sympathy,  since  they  were  considered  to  be  one-sided, 
or  they  were  thought  to  show  evidence  of  gross  ignorance, 
or   the    wording   produced    anger   and    was    supercilious   or 
overbearing.     The    psychologist,    on    the     other   hand,    has 
sometimes  tried  to  make  the  term  psychiatry  synonymous 
with  the  ideas  and  the  behavior  of  one  psychiatrist  whose 
superficiality  was   recognized   by  his  professional  confreres, 
but  whose  'holier  than  thou'  attitude  or  whose  expressions 
of  superiority  have  incited  the  psychologist  to  sarcasm,  abuse, 
denunciation,  or  pity.     In  some  cases,  it  is  apparent    that 
the  physician,  jealous  or  fearing  lest  some  of  his  licensed 
prerogatives,   or  lest  some  of  his  assumed  functions  might 
be  encroached  upon,  or  that  others  might  develop  a  clientele 
of  potential  financial  value,  has  set  himself  upon  a  pedestal 
of  supposed  knowledge  of  the  whole   mental   and   physical 

1  Paper  read  before  the  American  Psychological  Association,  December  29,  1921, 
as  part  of  a  Symposium  on  Psychology  in  its  Social  Relations. 

241 

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242  SHEPHERD  IVORY  FRANZ 

life  and  character  of  the  individual.  He  has  charged  the 
psychologist  with  incompetency  in  dealing  with  people, 
because  the  latter  has  not  taken  the  trouble  to  graduate 
from  a  medical  college,  and  because  he  is  not  willing  to 
accept  uncritically  all  that  the  particular  psychiatrist  be- 
lieves. The  criticizing  psychologist,  on  the  other  hand, 
wonders  how  the  physician  acquired  his  supposed  superior 
knowledge  of  mental  phenomena  when  his  medical  training 
of  about  4,000  hours  comprised  instruction  in  psychology 
and  psychiatry  amounting  to  about  60  hours  or  less. 

Similar  personal  verbal  encounters  will  doubtless  recur 
and  with  the  same  result  as  in  the  past.  Each  of  the  com- 
batants will  have  shot  at  the  other  without  making  a  hit, 
and  the  only  difference  between  such  a  discussion  and  a 
French  duel  is  that  after  the  duel  the  combatants  fall  upon 
each  other's  neck  and  kiss.  Up  to  the  present  time,  so 
far  as  my  knowledge  goes,  most  psychiatrists  as  such  will 
not  kiss  a  psychologist,  nor  will  most  psychologists  kiss  a 
psychiatrist  as  such. 

The  criticism  of  individual  psychiatrists  or  of  individual 
psychologists  may  be  a  necessary  and  often  a  commendable 
performance  to  prevent  an  undue  exhibition  of  what  the 
Freudians  call  a  homo-sexual  trend,  viz.,  egotism.  Such 
criticisms,  unless  the  individual  recognizes  and  accepts  his 
temporary  position  as  a  patient  who  is  being  psychoanalyzed, 
may  be  amusing  for  the  spectators,  but  in  the  words  of 
the  comic  supplement  "it  don't  mean  anything."  Further- 
more, the  generalization  from  one  case  is  a  recognized  method 
of  unscientific  procedure  which  should  have  no  place  in 
either  medical  or  psychological  literature. 

This  is  the  first  point  of  importance.  Let  us  recognize 
and  remember  that  there  are  all  degrees  of  psychiatrists 
and  all  degrees  of  psychologists,  that  there  are  differences 
in  specialization  as  well  as  in  amount  of  knowledge  a  man 
may  have,  that  some  of  each  group  are  positively  ignorant 
and  that  others  are  negatively  learned,  and  that  blatancy, 
obstinacy,  intolerance,  puerility,  and  quibbling  are  neither 


PSYCHOLOGY  AND  PSYCHIATRY  243 

characteristic  nor  absent  because  of  the  occupation  or  title 
or  self-advertisement  of  the  individual.  Let  us,  therefore, 
confine  ourselves  to  the  subjects  psychology  and  psychiatry, 
and  to  the  psychologist  and  the  psychiatrist  in  general,  and 
exclude  the  individual. 

Psychiatry  is   much   more  easily  defined  at  the  present 
time  than  is  psychology.     The  facts  or  conditions  that  con- 
stitute the  field  of  psychiatry  are  more  generally  accepted 
than  those  of  psychology.     The  psychiatrist  is  by  etymo- 
logical   derivation    a    mental    healer,    he   is    concerned   with 
the  cure  of  those  who  exhibit  'variations  from  their  usual 
or  normal  way  of  thinking,  feeling,  and  acting.'     In  practice 
he  also  usually  deals   with  feeblemindedness,  which  is   not 
a  deviation  from  the   individual's   normal  or  usual,   but  a 
continued    or    a    continuing    state.     Psychiatry,    like    other 
specialized  divisions  of  the   practice  of  medicine  or  surgery, 
is  an  application  of  facts  and  principles  to  certain  practical 
problems  dealing  with  the  diagnosis,  with  the  treatment  or 
care   of  patients,   and   with   the   prevention   of  pathological 
conditions. 

It  would  be  presumptuous  for  me  to  try  to  harmonize 
the  conflicting  views  of  the  professional  psychologists  at 
this  time  respecting  the  definition,  the  scope,  and  the  methods 
of  psychology.  It  would  not  be  bravery,  but  unthinking  rash- 
ness, to  attempt  to  decide  between  the  obviously  opposing 
views,  to  decide  which  is  pure  and  virtuous  and  which  is 
improper  and  evil  and  corruption.  I  respect  the  introspec- 
tionist's  severe  individual  in  the  nun's  drab  habit,  I  look 
with  pleasure  on  the  ballet  dancer  of  Miss  Calkins's  'True 
Behaviorism,'  I  see  beauty  in  the  Miss  Psychology  clothed 
by  Warren  in  the  fig-leaf  costume,  but  I  also  approve  what 
others  may  call  the  brazen  nakedness  of  Watson's  'Physio- 
logical Behaviorism.'  I  can  see,  however,  that  while  the 
garb  is  of  some  importance,  more  to  others  than  to  me, 
the  fundamental  is  the  same.  Regardless  of  the  outward 
coverings,  psychology  is  and  her  beauty  or  ugliness  is  de- 
pendent upon  the  eye  of  the  beholder.  She  may  be  described 


244  SHEPHERD  IVORY  FRANZ 

in  terms  of  brass  instruments,  or  measurements  of  time  and 
space  and  energy,  as  mental  science,  as  behavior,  as  the 
study  of  psychical  processes,  or  as  the  science  of  the  facts 
or  content  of  experience,  but  in  every  case  there  is  meant 
what  historically  and  popularly  has  been  known  as  mind. 

With  two  of  the  parts  or  divisions  of  psychology  we  must 
concern  ourselves.  These  are  abnormal  psychology  and 
pathological  psychology  or  psychopathology.  It  is  these 
two  fields,  their  relations  and  dependencies,  which  give  the 
clue  to  so  many  of  the  disputes  of  the  past,  and  which  if 
properly  understood  should  bring  about  a  much  better  under- 
standing between  psychiatrists  and  psychologists. 

The  field  of  abnormal  psychology  can  best  be  understood 
in  terms  of  the  distribution  curve.  We  define  the  normal 
as  that  which  is  near  the  average  or  the  medium,  and  con- 
versely we  define  the  abnormal  as  that  which  deviates  greatly 
from  the  average  or  the  median.  Such  a  definition  can  be 
applied  to  the  individual's  sense  endowment,  to  his  mental 
processes,  to  his  behavior  in  relation  to  his  environment,  or 
to  social  activities.  It  carries  no  teleological  meaning.  It 
does  not  say  that  the  things  we  speak  of  should  have  a  cer- 
tain extensity,  or  intensity,  or  speed,  or  number.  It  does 
not  define  the  thing  in  terms  of  'should  be/  or  'might  be,' 
or  'ought,'  but  solely  in  terms  of  'is.'  Abnormal  psychology, 
therefore,  deals  with  the  extremes,  with  the  hypernormal 
traits  and  individuals,  as  well  as  with  subnormal  activities 
and  combinations  of  function.  The  distinction  has  been 
drawn  that  pathological  psychology  and  patho-psychology 
stress  the  psychological  .aspects  of  the  thing  under  consid- 
eration, while  psycho-pathology  stresses  the  pathological 
character.  All  three  terms,  however  they  be  otherwise 
differentiated,  involve  the  concept  of  disease  or  disorganiza- 
tion which  prevents  proper  (not  the  usual  or  average  or 
the  median)  function.  Normal  in  contradistinction  to  patho- 
logical means  the  desirable  or  the  necessary.  An  individual 
who  shows  an  intelligence  quotient  of  20  is  abnormal,  and 
he  may  also  be  pathological.  One  who  passes  the  Army 


PSYCHOLOGY  AND  PSYCHIATRY  245 

Alpha  with  a  perfect  score  of  212  is  also  abnormal,, but  not 
probably  pathological.  The  man  of  80  who  retains  the 
intellectual  vigor  which  he  showed  at  40  is  abnormal,  but 
decidedly  not  pathological.  He  who  at  80  exhibits  mental 
deterioration  shows  only  what  more  than  90  per  cent  of 
individuals  of  that  age  show,  but  he  is  certainly  pathological. 

Psychiatry,  as  an  art  or  an  application  of  science  looking 
towards  the  cure  of  those  who  are  mentally  diseased,  bears 
the  same  relation  to  the  underlying  science  of  psychology 
as  any  other  technical  application  bears  to  its  fundamental 
science.  Psychiatry  has  relations,  however,  to  many  funda- 
mental sciences  and  not  alone  to  psychology.  It  must  take 
from  pathology,  from  physiology,  from  chemistry,  from 
bacteriology,  and  from  a  host  of  other  sciences  what  it 
needs  to  bring  about  the  desired  ends,  in  treatment  or  cure, 
and  in  prevention.  It  does  need  the  fundamental  facts  of 
psychology,  those  of  sensation  and  perception,  those  of 
action  and  the  will,  those  of  feeling  and  emotion,  those 
of  character  and  personality,  and  those  of  the  mental  life 
of  the  child  and  of  the  adult.  Regardless  of  the  attitude 
one  may  take  with  respect  to  the  value  of  dissection  as 
giving  facts  of  functional  or  use  value,  it  is  true  that  one 
must  know  the  names,  colors,  and  textures  of  the  parts 
of  which  a  complex  machine  is  composed  before  one  is  able 
to  speak  of  the  spatial,  temporal,  and  forceful  relations  of 
the  parts. 

And  it  is  in  just  this  direction  that  psychiatry  has  taken 
a  peculiar  slant.  Anatomy,  physiology,  chemistry,  bacteriol- 
ogy, pathology,  are  thought  to  be  necessary  preliminaries 
to  the  understanding  of  certain  bodily  functions  with  which 
the  psychiatrist  must  deal,  but  the  psychiatrist  usually  denies 
the  necessity  of  understanding  the  methods  and  the  results 
of  psychology  in  relation  to  mental  things.  Because  in  a 
technical  psychological  journal  an  article  appears  which 
his  previous  education,  or  rather  lack  of  education,  has  not 
fitted  him  to  read  with  understanding,  he  considers  the 
modern  laboratory  psychology  to  be  futile  and  entirely 
unpractical.  For  him  and  his  work  it  has  no  meaning. 


246  SHEPHERD  IFORY  FRANZ 

But,  why  should  it  convey  a  meaning  to  him?  Is  it 
possible  to  get  for  one's  work  the  meaning  of  chemistry 
or  of  physics  without  special  training  and  study?  Is  it 
necessary  to  assume  that  psychology  and  its  methods  should 
be  simplified  to  the  extent  that  the  reading  of  an  intro- 
ductory text  is  all  sufficient  for  the  understanding  of  the 
details  of  research?  To  the  last  question  psychiatry  has 
answered  vociferously  "Yes,"  but  to  the  former  question 
psychiatrists  are  forced  to  answer  meekly  "No." 

The  difference  in  attitude  is  understandable  when  one 
knows  something  of  the  history  of  medicine.  We  need 
consider  only  one  analogy,  that  of  chemistry.  The  value 
of  chemistry  in  medical  practice  has  long  been  recognized, 
but  the  advances  in  chemistry  since  the  time  when  it  was 
an  almost  exclusive  medical  discipline  have  been  numerous 
and  varied.  These  advances  have  been  due  to  the  develop- 
ment of  a  group  of  chemical  specialists  whose  interests  have 
not  centered  on  the  diagnosis  and  treatment  of  the  sick, 
but  solely  in  the  discovery  of  new  facts  of  a  chemical  order. 
There  have  also  developed  a  group  of  specialized  medical 
chemists — the  physiological  or  biological  chemists — with 
divided  medical  and  chemical  interests,  who  are  the  go- 
betweens  or  the  mediators.  They  cull  from  the  researches 
of  the  silica  chemist,  from  those  of  the  organic  chemist, 
from  those  of  the  physical  chemist,  and  from  those  of  other 
specialized  chemists  what  appears  to  be  applicable  to  the 
work  and  welfare  of  the  body,  and  they  apply  this  knowledge 
in  their  own  specialized  laboratories.  After  the  intermediary 
steps  have  been  taken,  the  results  are  given  to  the  physician 
to  further  apply.  A  similar  division  of  labor  and  the  steps 
towards  partial  application  exist  between  most  of  the  other 
fundamental  medical  sciences  and  the  practice  of  medicine, 
with  the  notable  exception  of  psychology. 

Theoretically,  and  to  a  certain  extent  practically,  abnor- 
mal psychology  and  psychopathology  intervene  between 
psychology  and  psychiatry,  but  as  intermediate  kinds  of 
technology  with  groups  of  workers  they  do  not  exist.  A 


PSYCHOLOGY  AND  PSYCHIATRY  247 

few  are  engaged  in  the  fields  bordering  upon  both  psychology 
and  psychiatry.  Without  laboratory  training  some  psychia- 
trists consider  themselves  psychopathologists,  and  there  are 
few  psychologists  who  have  adequate  training  in  first-hand 
acquaintance  with  the  different  kinds  of  abnormalities  in  the 
mental  diseases. 

A  psychiatric  criticism  of  psychology  that  has  had  vogue 
is  that  the  psychologist  as  an  analyst  has  dissected  the  mind, 
and  metaphorically  cut,  mounted,  and  examined  it  through 
the  microscope,  but  that  he  has  devoted  little  or  no  attention 
to  the  interrelations  and  importances  of  the  things  the 
psychiatrist  has  seen  and  described.  Because  of  this  psy- 
chology is  said  to  have  no  value  in  psychiatry.  I  am  quite 
willing  to  grant  the  validity  of  the  conclusion,  but  I  object 
to  the  argument.  I  am  quite  willing  to  admit  at  the  same 
time  and  in  the  same  sense  that  anatomy,  histology,  physi- 
ology, chemistry,  physics,  and  bacteriology  have  no  value 
in  psychiatry.  The  analyses  made  in  these  scientific  pur- 
suits have  only  indirect  values.  The  workers  have  not,  and 
are  not  expected  to  have,  direct  interest  in  the  advancement 
of  psychiatry.  It  is  the  right  of  the  psychiatrist  to  take 
what  he  will,  or  to  have  it  adapted  to  his  own  use  by  an- 
other. But  even  though  all  of  the  facts  may  not  be  of 
equal  value,  and  even  though  we  may  admit  that  the  ana- 
tomical facts  of  a  psychological  kind  are  not  equally  valuable 
in  the  care  of  the  mentally  diseased,  it  is  true  that  some 
of  them  must  be  known  and  understood.  While  the  analogy 
is  not  to  be  followed  out  completely  it  may  be  said  that 
the  psychiatric  attitude  towards  analytic  psychology  is  much 
the  same  as  that  of  many  drivers  of  automobiles  towards 
their  machines.  A  few  obvious  gross  details  are  all  they 
are  willing  to  admit  to  be  necessary  for  the  running  of  a 
machine.  The  places  where  the  feet  must  be  placed,  the 
hands  and  water  and  gas,  are  apparently  all  that  are  needed 
for  the  operation  of  the  machine  in  health.  It  is  when  the 
car  will  not  work  that  its  behavior  is  then  described  in 
terms  of  depression,  dissociation,  repression,  egocentric  reac- 


248  SHEPHERD  IVORY  FRANZ 

tions,  regression,  and  the  like.  So  far,  so  good,  but  more 
anatomical  knowledge  is  needed  before  the  car  can  be  placed 
in  running  order.  Its  anatomy,  as  well  as  its  physiology, 
must  be  partly  understood.  The  reason  for  some  of  the 
common  disabilities,  such  as  flat  tires  and  the  like,  may 
be  learned  from  a  casual  anatomical  examination,  but  in 
those  cases  in  which  the  driver  does  not  know  the  difference 
between  the  vacuum  tank  and  the  magneto,  his  ability  to  care 
for  the  machine  is  greatly  reduced.  When  the  engine  coughs, 
spits,  and  stops,  the  symptoms  point  to  inadequate  food 
supply.  But  they  may  also  be  due  to  other  physiological 
dissociations.  If  the  psychiatric  driver  does  not  know  more 
than  that  the  machine  has  a  kind  of  catatonic  reaction  he 
may  spend  hours  on  a  lonely  road  trying  to  locate  and  remedy 
the  trouble. 

Conversely,  the  psychologist  who  knows  the  weights, 
the  sizes,  the  shapes,  the  colors,  and  the  intimate  composi- 
tions of  the  parts  of  a  machine  will  not  infrequently  find, 
after  the  pieces  have  been  laid  out  and  measured,  that 
putting  them  together  again  is  a  task  of  a  different  order. 
He  may  discover  many  apparently  superfluous  parts. 

Psychology  is,  however,  becoming  more  and  more  dy- 
namic, even  in  the  psychiatric  sense.  More  effort  is  being 
made  to  understand  interrelations  and  dependencies,  just  as 
in  present-day  anatomy  it  is  no  longer  deemed  sufficient 
to  describe  and  classify  but  to  use  the  facts  to  illustrate 
functional  relations.  But  even  though  psychology  become 
entirely  functional  or  dynamic,  there  is  no  reason  to  assume 
that  the  facts  or  explanations  can  be  carried  over  bodily 
into  psychiatry.  There  must  be,  in  the  same  way  as  between 
anatomy  and  medical  practice,  close  connecting  links.  It 
is  here  that,  in  different  senses,  abnormal  psychology  and 
psychopathology  belong.  They  are  psychological-psychia- 
tric intermediaries. 

In  psychology  the  deviations  are  of  interest  because 
exaggerations  and  diminutions  frequently  point  out  relations 
that  are  not  obvious  in  the  normal.  From  the  standpoint 


PSYCHOLOGY  AND  PSYCHIATRY  249 

of  psychology  it  makes  no  difference  whether  or  not  the 
abnormality  be  associated  with  a  pathology.  In  psychiatry 
the  important  thing  is  the  combination  of  phenomena  point- 
ing to  disease  types,  or  giving  indications  of  prognosis  or 
treatment.  Because  in  both  psychology  and  psychiatry  a 
knowledge  of  abnormalities  and  of  pathological  conditions 
are  of  value,  more  and  more  investigations  must  be  made 
if  advances  are  to  be  expected.  It  is  here  that  abnormal 
psychology  and  psychopathology  find  their  work.  They  will 
serve  to  benefit  both  psychology  and  psychiatry. 

Extreme  enthusiasm  for  a  cause  and  an  excessive  damna- 
tion of  what  is  believed  to  be  opposing  that  cause  are  charac- 
teristic of  the  fanatic  and  the  reformer.  During  the  past 
few  years  there  has  been  an  exaggeration  of  one  aspect  of 
psychopathology — psychoanalysis — which  in  certain  quar- 
ters of  psychiatry  has  produced  a  reaction  against  psychology 
and  which  in  certain  psychological  quarters  has  produced  a 
reaction  against  psychiatry.  But  this  is  the  history  of  many 
scientific  advances.  To  counteract  the  many  forces  advo- 
cating cults  it  is  important  that  both  psychologists  and 
psychiatrists  study  and  keep  in  mind  the  mental  epidemics, 
and  recognizing  their  virulence  and  their  usually  short  .dura- 
tion, take  scientific  hygienic  measures  to  preserve  their  own 
mental  health  and  stability.  This  will  best  be  accomplished 
when  there  are  more  psychological  psychiatrists  and  more 
psychiatric  psychologists,  as  well  as  more  real  abnormal 
psychologists  and  more  real  psychopathologists. 


124915 


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14  1930 


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10  193* 


DEC  2      1935 


JUL  22 


SEP  8     I960 

Form  L-9-35m-8,'28 


ANGSLJBS 


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